The advocacy process in Canadian community health nursing: A collaborative ethnography.

AIMS: To shed light on the process of advocacy in the context of community health nursing, through a methodology inspired by the epistemologies of the South. DESIGN: We conducted a collaborative ethnography in a community health centre in Canada. METHODS: de Sousa Santos' epistemologies of the South, a typology of advocacy and main themes from historic research informed the methodology. Data were collected between 2016 and 2018 through 420 h of fieldwork observations and three group discussions, including a collective process to co-construct interpretations with participants. Twenty-one nurses participated in the study. RESULTS: Nurses had sufficient work flexibility to practice advocacy actions focused on individuals and groups. They also engaged in attempts at policy reform in the form of defending access to appropriate care and changing the mode of care organization. However, these were curbed by bureaucracy and administrative rules, resulting in the eventual dismissal of health promotion actions and experiences of moral distress. CONCLUSION: Despite the political climate of their work environment impeding social justice agendas, nurses' advocacy practices showed a persistence of moral values and ideals in coherence with the regional nursing legacy. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Acting at the organizational level and involving field nurses in decision making are potential avenues for increasing policy advocacy efficacy. IMPACT: Examining contexts through another epistemic lens and methods of research drawing on history and anthropology has shed light on a process of advocacy. This research shows that organizations need to equip themselves with mechanisms to promote the sharing of realities between nurses, thereby building collective advocacy. REPORTING METHOD: The research adheres to the EQUATOR guidelines with SRQR and COREQ methods. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Travail de care des travailleuses de la santé en situation de pandémie de COVID-19 : quel engagement de la part des autorités gouvernementales?

La COVID-19 a pressé les gouvernements à intervenir à l'aide de données partielles sur l'efficacité des moyens. Les femmes sont particulièrement touchées car elles sont plus nombreuses à s'occuper des autres. Cette étude a pour but de comprendre l'influence des décisions politiques sur les conditions de vie et de travail des travailleuses de la santé. Une analyse des interventions gouvernementales de santé publique du Québec et des revendications des travailleuses de la santé retrouvées dans les documents journalistiques et les communiqués de presse officiels du gouvernement (13 avril au 1er juillet 2020) a été effectuée. Les résultats démontrent le manque de reconnaissance des autorités face à certains types de care, ainsi qu'une inadéquation dans les moyens de prise en charge pour prendre soin de la population. Le peu de reconnaissance des conditions de vie et de travail lors de décisions politiques engendre une répartition inéquitable des fardeaux associés à la pandémie.

Travailler auprès des familles indigentes : les gardes-malades catholiques à l'avant-garde de la santé communautaire au Canada (1934-1959).

Several articles in the Bulletin des gardes-malades catholiques and the Bulletin des infirmières catholiques du Canada refer to the personalist philosophy. In this article, we posit that this philosophy influenced the "social sense" promoted by the Church among nurses from 1934 to 1959 and that it enabled the transfer from a charitable model to one challenging the social order. We present the Bulletins as agents of resistance to a science perceived as being devoid of morality, in the face of a growing administrative technocracy seen as detrimental to human beings' living conditions. These sources allow us to give a different interpretation to nurses' contribution to the modernization of care given to the poorest families. We contend that it is beyond institutions and inspired by personalim that French-speaking Catholic nurses laid the groundwork for community health in Canada.

Plusieurs textes du Bulletin des gardes-malades catholiques et du Bulletin des infirmières catholiques du Canada se réfèrent à la philosophie personnaliste. Dans cet article, nous faisons l'hypothèse que cette philosophie a influencé le « sens social  ¼ promu par l'Église auprès des gardes-malades de 1934 à 1959 et qu'elle a favorisé le passage du modèle charitable à celui d'une contestation de l'ordre social. Nous présentons les Bulletins en tant que moteurs de résistance face à une science considérée comme dépourvue de moralité et face à la montée d'une technocratie administrative représentée comme nuisible pour les conditions d'existence de l'humain. Ces sources nous permettent d'interpréter différemment la contribution des gardes-malades à la modernisation des soins dispensés auprès des familles les plus démunies. Nous soutenons que c'est à l'extérieur des institutions et inspirées par le personnalisme que les gardes-malades francophones catholiques ont jeté les bases de la santé communautaire au Canada.

"Don't smoke in public, you look like trash": An exploratory study about women's experiences of smoking-related stigmatisation and the connection to neighbourhood-level deprivation.

In this exploratory qualitative study we used Goffman's theory of stigmatisation to examine how women experience smoking-related stigma in relation to neighbourhood-level deprivation. From an existing cohort, we recruited fifteen women who smoked. We found differences in the women's experiences and abilities to negotiate and avoid a stigmatised smoking identity based on neighbourhood-level deprivation. Women in high-deprivation neighbourhoods described limited access to such places and this restricted their abilities to 'pass' as non- or not-quite-smokers and avoid smoking-related stigmatisation. We discuss the implications of the findings in relation to social-spatial inequalities in health and public health policy.

Young adults' experiences of neighbourhood smoking-related norms and practices: A qualitative study exploring place-based social inequalities in smoking.

In this qualitative exploratory study we asked how smoking among young adults relates to the local neighbourhood context to better understand place-based social inequalities in smoking. We used data collected through focus groups with young adults from four economically diverse neighbourhoods in Montreal, Canada. Using the collective lifestyles framework to guide data analysis, we examined within and between neighbourhood social norms, practices, and agency. We found that some smoking-related social norms, practices and agency were particular to neighbourhoods of the same socio-economic status (SES). For example, permissive smoking-related social norms in low-SES neighbourhoods made it difficult to avoid smoking but also reduced local experiences of smoking-related stigma and isolation. In high-SES neighbourhoods, strong anti-smoking norms led to smoking in secret and/or amidst 'acceptable' social settings. Findings may inform future investigations and local-level interventions focused on this age group.